Presentations 2020: Restorative

370 - Complexity of Endodontic cases treated in secondary care: An audit

R Long A Dutta M Thomas M Vianna
Presented by: Ruby Long
Cardiff Dental Hospital

Aim: To determine the complexity of endodontic cases being treated by Dental Core Trainees (DCTs) using the ‘2019 English Commissioning Guidance for Restorative Dentistry’ and the ‘2001 Index of restorative treatment need (IORTN)’. Method: The DCT endodontic waiting lists were identified and notes were requested from medical records. Ambiguities were highlighted when using the complexity grading systems and following discussions between a DCT and two Restorative Dentistry Consultants a standardised protocol was formed. A trial sample was then examined by a DCT and a Consultant, a complexity grading was assigned to each of the prospective endodontic treatments using the new ‘2019 English commissioning guidance’ and the ‘IORTN’. Once a Kappa score was calculated for each of the systems to confirm interexaminer reliability, 62 sets of patient notes and radiographs were the examined. The results were then analysed using excel. Results: Using the IORTN, 45% of patients being treated by DCTs were complexity 3, 52% were complexity 2 and 3% were complexity 1. Compared with the ‘2019 English commissioning guidance’ where 32% of patients being treated by DCTs were complexity 3, 39% were complexity 2 and 29% were complexity 1. Conclusion: This data shows that The ‘2019 English commissioning guidance' categorises cases to a lower complexity level than the ‘IORTN’. Both complexity grading systems show that DCTs are completing a large amount of complex cases, with supervision. One third of cases were graded complexity 1 and therefore don’t require treatment in a secondary care environment. Complexity grading has not been used previously at UDH when accepting cases for treatment. The use of a complexity grading system, taking account of commissioning differences in Wales could be adopted. A review of acceptance criteria taking account of training needs is appropriate. This would facilitate appropriate use of resources within a secondary care and training environment.
Consent Statement: There are no details on individual patients reported within the abstract.

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